HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -Q , Permit Number:
RECEIVED MAY 2 2 1017
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION
Address: 114 QUEEN ANN CT., FORT PIERCE, FL 32949
Legal Description: QUEENS COVE UNIT 2 BLK 24 LOT E(OR 3683-2336)
1`t 1`I
Property Tax ID#: +717"702-0031-000-5 Lot No.E
Site Plan Name: Block No. 24
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAI LE
D DESCRIPTION QF WORK
INSTALLATION OF 2 ACCORDION HURRICANE SHUTTERS
CONSTRUCTION'i'NFORM
ATION `N
Additional work toe nertormed under this permit—check all app y:
HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
0 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ $4,730.89 Utilities:Sewer O Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name ROLAND BLANCHARD Name: JAMES SILVIA
Address:114 QUEEN ANN CT Company: PALM COAST FL COMMERCIAL DEVELOPMENT
City: FORT PIERCE State:_ Address: 505 BEACHLAND BLVD.#2
Zip Code: 34949 Fax: City: VERO BEACH State:FL
Phone No.(772)448 8780 Zip Code: 32963 Fax: 772-299-1958
E-Mail: Phone No. 772 299 1955
Fill in fee simple Title Holder on next page(if different E-Mail: GIOVANNA@PALMCOASTSHUTTERS.COM
from the Owner listed above) State or County License: CBC 1258218
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQNSTRUCTION LIEN LAIN INFORMATIaN
DESIGNER/ENGINEER: _N _ -..
of Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commen ' ordin our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF INDIANRWERCOU COUNTY OFND-RIVER COUM
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 'Z7 day of A`'P IL_ 20 L'I—by this_day of A1.j 20 4 by
ROLAND BLAI`kHARD JAMES SILVIA
(Name of p son acknowledging) (Name of p son a owledging)
/�US�IAI C
(Signat re 9f Notary Public-State of Florida) (Signature of F41 ary Public State of Florida)
Personally Known OR Produced Identification x Personally Known
Type of Identification Produc Type of Identification Prod egW45
No
�.>P . Giovanna Drausal
� F�� v my ST gt�esion FF 193077
Commission No. ,s` }= I Commission No. off' 6x aV aenol9
�§RS�I A1SSiI�i� Fd'su<
EXPIRES:Oil 1,
e
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS